All codes
Y804
Y804 – Y804
OHIP Other Code · Schedule of Benefits
When to Use
- Use Y804 to report the administration of a publicly funded vaccine when no other visit fee is claimed for the patient encounter.
- Apply this code when a patient presents exclusively for an immunization service provided by a nurse or physician where the primary purpose of the visit is the injection itself.
Common Pitfalls
- Billing Y804 in addition to a consultation or assessment code (e.g., A007) is redundant and will result in a rejection or audit flag for unbundling.
- Failing to include the specific vaccine product code in the claim submission will lead to a rejection as Y804 is an administrative tracking code for the service event.
Billing Tips
- Ensure the vaccine product code is linked correctly to the Y804 service event to satisfy Ministry reporting requirements for immunization coverage.
Provider Fee$0.00
Surgical Assistant Fee$18.70
Non-Anaesthetist Fee$24.51
Effective: April 1, 2026
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